KATHLEEN LENINGER, PT & DPT.
“I have hip pain. Well, it’s sorta my hip… or maybe my back too? I’m not sure.” This is a comment that we hear often. Where does the hip start and the backstop? Is my hip on the front too? What about that side part? Welcome to the pelvis. The pelvis serves as the connection between the body and legs, which is so important for a runner… because you need to use your legs to move your body!
The pelvis is made up of three main bones: an iliac bone on each side, which meets in the front at the pubic symphysis, and the sacrum bone on the back.
Stability at the pelvis is difficult to achieve because our normal postural changes (i.e. anterior tilt) encourage the weakness of the abdominals and tightness of the low back. Think about your abdominals for a second: they are the only thing protecting your organs underneath from the outside world! That is a big job.
When it comes to strengthening, the fitness world loves to push you to take the bigger step, lift the heavier weight, complete your fastest crunches, etc. These cues encourage more pelvic instability! I think of those little wooden mannequins when I picture correct pelvic stability: my pelvis is level (relative to the ground) from the strength of my abdominals and glutes, and then I only move however far I can lunge, lift, or lower without losing that stability.
Pre and post-pregnancy, this is even more important because your body is growing in the pelvic area. With your center of mass growing forward, it becomes harder to keep your abdominals engaged. With an increase in hormones (especially relaxin) the joints of the three pelvic bones are laxer, so you need even more strength to keep your pelvis stable and to prevent pain. This is why pelvic pain is so common AND why pelvic stability is so important!
Now, let’s talk about how to master pelvic stability. Start with the boring stuff: bridges, abdominal marching, fire hydrants, etc. Don’t focus on how far you are going, but instead on how stable you keep your pelvis. Once you nail this, you can move to more difficult movements including lunges, split squats, RDLs, etc. The key is to still focus on the stability of the movement. Mastering the multiplanar and rotational activities (hello curtsy squats and plyometrics) is an even more advanced step. If you skip one of these steps OR start to feel pain, you know it’s time to go back to the basics and refocus!
Not sure you are doing it right or can’t find your pelvis? Let’s talk!